Neural Tube Defects Prevention with Folic Acid Supplementation and Fortification: A Comprehensive Systematic Review
Keywords:
folate supplementation, folate fortification, neural tube defectsAbstract
Background: Neural tube defects (NTDs), affecting 1–2 per 1000 live births globally, leading to significant health and economic burdens. Folate supplementation and food fortification are crucial for prevention. The aim of this systematic review is to comprehensively evaluate the role of folate fortification and supplementation in reducing the incidence of NTDs. Methods: The review adhered to PRISMA 2020 standards and analyzed full-text English literature from 2014 to 2024. It excluded editorials, review papers from the same journal, and submissions lacking a DOI. Literature sources included PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 500 articles were retrieved from online databases (PubMed, SagePub, SpringerLink and Google Scholar). After three rounds of screening, five articles directly relevant to the systematic review were selected for full-text reading and analysis. Conclusion: Folic acid supplementation and fortification are effective in lowering global NTD rates, despite disparities in implementation and outcomes, especially in low-resource areas.
References
van Gool JD, Hirche H, Lax H, De Schaepdrijver L. Folic acid and primary prevention of neural tube defects: A review. Reprod Toxicol. 2018 Sep;80:73–84.
Kancherla V, Wagh K, Priyadarshini P, Pachón H, Oakley GP. A global update on the status of prevention of folic acid-preventable spina bifida and anencephaly in year 2020: 30-Year anniversary of gaining knowledge about folic acid’s prevention potential for neural tube defects. Birth Defects Res. 2022 Dec 1;114(20):1392–403.
De-Regil LM, Peña-Rosas JP, Fernández-Gaxiola AC, Rayco-Solon P. Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database Syst Rev. 2015 Dec 14;2015(12):CD007950.
Keats EC, Haider BA, Tam E, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2019 Mar 14;3(3):CD004905.
Crider KS, Qi YP, Devine O, Tinker SC, Berry RJ. Modeling the impact of folic acid fortification and supplementation on red blood cell folate concentrations and predicted neural tube defect risk in the United States: have we reached optimal prevention? Am J Clin Nutr. 2018 Jun 1;107(6):1027–34.
Tinker SC, Hamner HC, Qi YP, Crider KS. U.S. women of childbearing age who are at possible increased risk of a neural tube defect-affected pregnancy due to suboptimal red blood cell folate concentrations, National Health and Nutrition Examination Survey 2007 to 2012. Birth Defects Res A Clin Mol Teratol. 2015 Jun;103(6):517–26.
Centeno Tablante E, Pachón H, Guetterman HM, Finkelstein JL. Fortification of wheat and maize flour with folic acid for population health outcomes. Cochrane Database Syst Rev. 2019 Jul 1;7(7):CD012150.
Turner MJ. Neural Tube Defects and Folic Acid Food Fortification in Europe. Am J Public Health. 2018 May;108(5):601–2.
Kancherla V, Botto LD, Rowe LA, Shlobin NA, Caceres A, Arynchyna-Smith A, et al. Preventing birth defects, saving lives, and promoting health equity: an urgent call to action for universal mandatory food fortification with folic acid. Lancet Glob Health. 2022 Jul;10(7):e1053–7.
Atta CAM, Fiest KM, Frolkis AD, Jette N, Pringsheim T, St Germaine-Smith C, et al. Global Birth Prevalence of Spina Bifida by Folic Acid Fortification Status: A Systematic Review and Meta-Analysis. Am J Public Health. 2016 Jan;106(1):e24-34.
Santos LMP, Lecca RCR, Cortez-Escalante JJ, Sanchez MN, Rodrigues HG. Prevention of neural tube defects by the fortification of flour with folic acid: a population-based retrospective study in Brazil. Bull World Health Organ. 2016 Jan 1;94(1):22–9.
Poletta FA, Rittler M, Saleme C, Campaña H, Gili JA, Pawluk MS, et al. Neural tube defects: Sex ratio changes after fortification with folic acid. PLOS ONE. 2018 Mar 14;13(3):e0193127.
Grosse SD, Berry RJ, Mick Tilford J, Kucik JE, Waitzman NJ. Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S. Am J Prev Med. 2016 May;50(5 Suppl 1):S74–80.
Kancherla V, Wagh K, Johnson Q, Oakley GP. A 2017 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Res. 2018 Aug 15;110(14):1139–47.
Arth A, Kancherla V, Pachón H, Zimmerman S, Johnson Q, Oakley GP. A 2015 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Res A Clin Mol Teratol. 2016 Jul;106(7):520–9.
Jalal CS, De-Regil LM, Pike V, Mithra P. Fortification of condiments and seasonings with iron for preventing anaemia and improving health. Cochrane Database Syst Rev. 2023 Sep 1;9(9):CD009604.
Wagh K, Kancherla V, Dorsey A, Pachón H, Oakley GP. A global update on the status of prevention of folic acid-preventable spina bifida and anencephaly in year 2022. Birth Defects Res. 2024 May;116(5):e2343.
Quinn M, Halsey J, Sherliker P, Pan H, Chen Z, Bennett DA, et al. Global heterogeneity in folic acid fortification policies and implications for prevention of neural tube defects and stroke: a systematic review. eClinicalMedicine [Internet]. 2024 Jan 1 [cited 2024 Jun 20];67. Available from: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00543-6/fulltext
Viswanathan M, Urrutia RP, Hudson KN, Middleton JC, Kahwati LC. Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2023 Aug 1;330(5):460–6.
Wilson RD, Genetics Committee, Wilson RD, Audibert F, Brock JA, Carroll J, et al. Pre-conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies. J Obstet Gynaecol Can. 2015 Jun;37(6):534–52.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Henni Purnasari, Mutia Juliana (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
